Viglianti Benjamin L, Wong Ka Kit, Wimer Stephanie M, Parameswaran Aishwarya, Nan Bin, Ky Christy, Townsend Danyelle M, Rubello Domenico, Frey Kirk A, Gross Milton D
Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Nuclear Medicine Service, Department of Veterans Affairs Healthcare System, Ann Arbor, MI, USA.
Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
Biomed Pharmacother. 2017 Apr;88:1038-1045. doi: 10.1016/j.biopha.2017.01.166. Epub 2017 Feb 7.
Blood glucose is routinely measured prior to F-fluorodeoxyglucose (FDG) administration in positron emission tomography (PET) imaging to identify hyperglycemia that may affect image quality. In this study we explore the effects of blood glucose levels upon semi-quantitative standardized uptake value (SUV) measurements of target organs and tissues of interest and in particular address the relationship of blood glucose to FDG accumulation in the brain and liver.
436 FDG PET/CT consecutive studies performed for oncology staging in 229 patients (226 male) at the Ann Arbor Veterans Administration Healthcare System were reviewed. All patients had blood glucose measured (112.4±34.1mg/dL) prior to injection of 466.2±51.8MBq (12.6±1.4mCi) of FDG. SUV measurements of brain, aortic arch blood-pool, liver, and spleen were obtained at 64.5±10.2min' post-injection.
We found a negative inverse relationship of brain SUV with increasing plasma glucose, levels for both absolute and normalized (either to blood-pool or liver) values. Higher blood glucose levels had a mild effect upon liver and blood-pool SUV. By contrast, spleen SUV was independent of blood glucose, but demonstrated the greatest variability (deviation on linear regression). In contrast to other tissues, liver and spleen SUV normalized to blood-pool SUV were not dependent upon blood glucose levels.
The effects of hyperglycemia upon FDG uptake in brain and liver, over a range of blood glucose values generally considered acceptable for clinical PET imaging, may have measurable effects on semi-quantitative image analysis.
在正电子发射断层扫描（PET）成像中，在注射氟脱氧葡萄糖（FDG）之前常规测量血糖，以识别可能影响图像质量的高血糖情况。在本研究中，我们探讨了血糖水平对感兴趣的靶器官和组织的半定量标准化摄取值（SUV）测量的影响，尤其关注血糖与脑和肝脏中FDG摄取的关系。
回顾了在安阿伯退伍军人事务部医疗保健系统为229例患者（226例男性）进行肿瘤分期的436例连续FDG PET/CT研究。所有患者在注射466.2±51.8MBq（12.6±1.4mCi）的FDG之前测量了血糖（112.4±34.1mg/dL）。在注射后64.5±10.2分钟获得脑、主动脉弓血池、肝脏和脾脏的SUV测量值。
我们发现，无论是绝对值还是归一化值（相对于血池或肝脏），脑SUV与血浆葡萄糖水平升高呈负相关。较高的血糖水平对肝脏和血池SUV有轻微影响。相比之下，脾脏SUV与血糖无关，但表现出最大的变异性（线性回归偏差）。与其他组织不同，归一化至血池SUV的肝脏和脾脏SUV不依赖于血糖水平。
在通常认为对临床PET成像可接受的一系列血糖值范围内，高血糖对脑和肝脏中FDG摄取的影响可能对半定量图像分析有可测量的影响。
